Achilles Tendinopathy

posted Aug 21, 2012, 5:23 PM by LASP Team   [ updated Aug 21, 2012, 5:26 PM ]

Achilles Tendinopathy is the term used to describe pain in the Achilles tendon. This is the tendon joining your calf muscles to your heel bone, which also happens to be your strongest tendon in your body.
Tendinopathy refers to the degenerative changes or breakdown in the structure of the tendon, resulting in a weakened and painful tendon.

This condition is commonly a result of overuse and can develop in any age; however it is more common in middle-age men (30-40yrs), along with athletes or highly active people.

Causes of Achilles Tendinopathy

There are numerous factors which can lead to the development of an Achilles Tendinopathy, however the most common factor is repetitive or prolonged activities which place strain on the Achilles tendon. Activities can include running, walking, or jumping.

  • Over-use: Too much sport or activity. This can come in the forms of a rapid increase in activity, too much training or inadequate recovery time (the tendon doesn’t have time to recover and adapt).
  • Underactivity: Not enough activity fails to load on the tendon adequately and can lead to similar degenerative changes as an overloaded tendon
  • Biomechanics: This can include reduced flexibility & stiffness in the a
    nkle (common after any acute ankle injury), poor foot biomechanics including increased foot pronation or rolling in of your foot along with muscle imbalances
  • Poor footwear
  • Obesity: This can lead to increased load on all your tendons, along with altered cell production throughout the body when overweight.
  • Diabetes


Signs, Symptoms & Pain

Pain is commonly located in the middle of the tendon or at the boney insertion of the tendon. Other common signs and symptoms include:

  • Morning or start-up pain/stiffness following a period of rest
  • Pain during activity (can often settle with a warm-up) or after walking/running/jumping activities
  • A sore Achilles tendon to touch
  • Formation of lump/swelling or thickening of the tendon
  • Weakness in the calf muscles or inability to lift up onto your toes.

Research reports that the best ma

nagement for tendinopathies lies in conservative management which can be provided and guided by your physiotherapist.
  • Load Modification – an initial reduction in load to assist in unloading the tendon and to enable a normal tendon healing response to develop. Your physiotherapist can also provide alternate cardiovascular exercise to maintain your fitness or weight loss goals
  • Exercise – exercise has been shown to be superior for tendon recovery and strengthening and your Physiotherapist can best prescribe you an appropriate load and dose of exercise to maximize improvements and avoid further overloading.
  • Footwear & Orthotics – orthotics and heal raises can also be effective in offloading your tendon and getting you back to your sporting goals.



There are multiple medical treatment options which can be provided by a general practitioner or a sports specialist. These treatment options tend only to be utilized once conservative physiotherapy management fails however can include nitric oxide patches or localized blood injections.


How long will it take for my tendinopathy to recover?

The time for your tendon to recover can be considerably varied from 3-18 months, much longer than muscles or bones take to recover. Even when tendon is pain free to a current level of activity, some degeneration still remains and a long-term maintenance program is often best to prevent recurrent flare-ups.


If you have any questions about your Achilles Pain, or would like it checked by one of our Physiotherapists, please contact us on (02) 4647 3373.